Medical review
Targeted probe and educate (TPE) topics and schedule of review
View this updated listing of targeted probe and educate (TPE) review topics.
Checklist: Ambulance
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for ambulance transports.
Checklist: Ambulance
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for ambulance transports.
Targeted probe and educate (TPE) round results: Evaluation and management services – emergency department visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency department visits TPE round results.
Targeted probe and educate (TPE) round results: Evaluation and management services – emergency department visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency department visits TPE round results.
Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient office visits
View TPE round results for evaluation and management services - outpatient office visits.
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing…
Facet joint interventions for pain management
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code…
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing…
Ambulance prior authorization - documentation checklist for medical professionals
Review this checklist to learn about the documentation requirements for medical professionals related to the repetitive, scheduled, non-emergency prior authorization program.